“The paradox of grief is that finding a way to live with the pain is what enables us to heal”.

Julia Samuel – Grief Works 2017

Valentine’s Day is a celebration of those we love and also aspire to love. It’s also a reminder of who we have loved and lost. For those still “stuck in grief” from the loss of a loved one this can be a particularly painful time. And because Valentine’s Day is such a public event, men and women who are still going through the grieving process, or perhaps stuck in it from long ago (because they never worked through their loss) are constantly reminded of this lost love by colleagues, friends and family who are celebrating their love for another, bringing home even more painfully what we no longer have.

As counsellors having worked with the bereaved, and as individuals having lost some of those close to us, we know only too well that to heal our grief we need to allow ourselves to feel the pain.

It would be good to clarify here what we mean by the terms grief and mourning.

Grief is the internal expression of loss. It is our thoughts and feelings, our emotional and behavioural response to the death of a loved one

Mourning is the outward expression of our grief, our external shared response to the loss, and it is influenced by our social and cultural rituals and customs.

But loss is not just about the loss of a significant other, it could also be the loss of your job, a hoped for promotion, it could be a physical loss like losing a limb or suddenly developing a health condition that changes how you now have to live your life.

With the loss of another person we are forced to consider the existential nature of our own being. We are talking here about a consideration of how we are in the world, an awareness that we are now feeling closer to death. A scary thought that elicits very complex and often disturbing emotions.

For both men and women grieving can be hard to do because of a childhood message from our parents, that it is “selfish” of us to talk about our own needs/wants. As a result, grief and loss might never be named, spoken about publicly, or talked through and shared with family and friends.

Grief and loss can also weigh us down in a practical sense, prompting issues around depression and anxiety, because of the sheer enormity of the change it can bring. One example of this might be the loss of a family’s main bread winner, and the thrusting of this role onto the partner. It can also be physical in the sense that a grief-stricken client will forget to look after themselves, indulging in drink or drugs to block out the painful feelings, over eating, or comfort eating as it is better known in this context. Alternatively, we can forget to eat properly through the sheer pain of a loss, leading to a loss of drive and energy from not fuelling our bodies.

This naturally leads us on exploring the different types of grief.

‘Normal grief’.

The grieving process requires us to acknowledge the loss and work our way through it, either by talking to friends or a therapist. Engaging in traditional mourning, such as attending a funeral, and taking bereavement leave is a good start. Typically, a loss takes between two and five years to really recover from, so part of the normal grieving process is accepting that you will be suffering for quite a while. Everyone has their own grief clock as we like to call it, so don’t listen to friends who tell you that you should be “getting over it by now.” You will know, helped by good support, when it is time to say you are no longer grieving.

With clients who come to us with grief or bereavement issues we are essentially helping them to come to terms with their loss, learn how to process and manage their sadness so that over time they can get on with their life and find new ways of being in the world.

It might be that they are at the very beginning of this particular journey, such as not accepting that this person has gone. Clients might do this by dwelling on that person to such an extent that they keep imagining they are still at the end of a phone or imagines seeing them in everyday places.

Alternatively, there are those who are simply unable or unwilling to embark on the grieving process at all. Or there might be what you could term "rushed grief" whereby we do all the things we are supposed to do when someone dies (arranging the funeral, sorting out their personal affairs etc) at an express pace so that we don’t go through the emotional side, the painful feelings a death brings up. Typically, when this happens everything seems OK at first, then you begin to experience sudden or uncontrolled tears when these supressed emotions come out later on. As therapists we talk about the 'coke bottle moment' whereby feelings we have suppressed suddenly explode much as how a shaken fizzy drinks bottle would if not opened with care.

Unresolved/Complicated grief

Grief can be normal, but it can also be made worse if it is ‘complicated grief’. Broadly this can happen when there are multiple losses all at once, such as 9/11 when thousands of City workers were lost to their families and work colleagues all at the same time. Or it can be the significant solitary loss we mentioned before, in which we never got to have that final conversation, or never got to talk about and resolve deep seated issues we had with that person and we are left feeling angry, frustrated and without a sense of closure.

Men and women – do they express grief differently?

For men in particular, loss and grief on anniversaries and calendar dates such as February 14th are particularly challenging as a result of them holding onto society’s view that men need to be strong and not show their emotions/vulnerability for fear of having their masculinity challenged. As children we may have heard our parents or teachers say Big Boys Don’t Cry” and this view and ‘shame’ around expressing one’s emotions has often continued long into their adulthood.

So, for men loss and grief can come without the outlet of tears because they won’t allow themselves to cry, or properly explore their feelings and emotions around life and death. But not letting ourselves cry is not the preserve of the male of the species, it just that men are often more likely than women to hold in their emotions because of societal norms around masculinity and mourning. Researchers suggest there is what might be called a “male model” of grief. Those men who tend towards this way of being will keep grief to themselves, make sure they appear strong in front of others and refrain from asking for help and support. This strong, silent, stoic approach is what they think is their role.

A “female model” of grief is one where one’s grief is shown to others’, the loss is talked about more openly and help and support are asked for more readily. Both men and women can identify with a ‘male’ or ‘female’ model of grief but as the title suggests the identification is often along more gendered lines.

Mental Health Issues & Unresolved Grief

Research studies estimate that 15-25 percent of mental health problems have been shown to be from unresolved grief so it is no wonder that when not properly worked through, grief and loss can have serious and long-term adverse health effects.

Grief: Is there a cure?

This brings us on to what are sometimes referred to as coping mechanisms, or ways of working with grief and loss. And it is often the behaviours we use to avoid the painful grieving process that causes us, and possibly the people around us, the most harm

The first step – and it is a painful one – is acknowledgement. That person has gone. They have reached the end, perhaps much earlier than they logically should have (a child for example). We have to face this by accepting that they have gone. Often the first stage of grief is denial and we have to get through this stage to then accept and acknowledge that this person has died. Grief is a process, and everyone will grieve in their own way and in their own time. Feelings such as denial of the loss, anger that that the person has died, depression that they have gone and are not coming back are all normal, and very usual reactions to loss.

What can really help is talking to another person about your loss and how you are feeling. In the therapy room we really encourage the bereaved family member to talk as much as they feel able to about their loss. How do you feel? Are you angry? Sad? Do you think that you can’t talk about the negative feelings you have about that person? If there is a voice inside you saying that it is selfish to feel relief, remorse or guilt, then let's explore that more. Perhaps, for example, they were the bread winner in your family and you are angry at them for leaving you with financial problems, or maybe you feel guilty because you are relieved they are no longer in your life as they did not make you happy or content? If you can't talk about the impact of your difficult emotions, then you are not going to be able to properly grieve the loss. Anger is a very common emotion when loss occurs, for a variety of complex reasons, and if not expressed properly can be turned inwards and lead to depression. Other research studies reveal that persistent, all consuming grief may, in and of itself, increase the risk of other illnesses, such as heart problems, high blood pressure, anxiety and depression. But grief in itself is not a mental illness, it is a natural response to loss. And the outcome of healthy grieving is where we once again get on with our life, feel engaged with others and the world around us whilst also remembering the loss we have gone through. In time it is hoped that the sadness we feel is replaced by happy memories of good times shared together.

As Julia Samuels writes in her wonderful book Grief Matters “Our culture is imbued with the belief that we can fix just about anything and make it better; or, if we can’t, that it’s possible to trash what we have and to start all over again. Grief is the antithesis of this belief: it eschews avoidance and requires endurance and forces us to accept that there are some things in this world that simply cannot be fixed”.

In our experience self -love and compassion for yourself as the one left behind is really important. It can take time to introduce and address this in the therapy, for example, if the client has low self -esteem or has never been able to express their needs and put themselves first. Also, unfortunately, there is nothing that depression and anxiety can’t make worse. When we suffer a loss or a bereavement it is very hard to consider, respect, and show good self -care in that moment. Typically we might address this by asking the client what the person who they have lost would want for them now?

No two people—no matter their gender—grieve alike. And it is important to remember that there is no right or wrong way to do it, as long as you do go through the grieving process. How an individual feels loss and mourns depends on many factors such as personality type, upbringing, cultural norms, their faith and previous losses they have had. There is a view that we grieve how we live, so if someone is stoic and closed in life this is how they will grieve, and if they are the type of person who has to talk through their problems and likes to engage with others then this is how they will grieve. What is important is that grief be expressed, that the person goes through the grieving process so they can come out the other end. We want to reach a place of integration where we can again feel engaged with life.

How to cope with grief- Summary

While experiencing loss is an inevitable part of life, there are ways to help cope with the pain, come to terms with your grief, and eventually, find a way to pick up the pieces and move on with your life.

Some suggestions that maybe helpful are:

Acknowledge your pain. And then let yourself feel it because it will eventually lessen.

Accept that grief can trigger many different and unexpected emotions. These are all normal.

Understand that your grieving process will be unique to you.

Seek out face-to-face support from people who care about you.

Support yourself emotionally by taking care of yourself physically. Eating properly, getting enough sleep and relaxing when you can will be help you to work through your grief.

Recognize the difference between grief and depression. If you think you are depressed then seek help from friends, your Doctor or a Counsellor,

Whatever your grief experience, it’s important to be patient with yourself and allow the process to naturally unfold.

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Dennis Rice and Ruth Dines are partners at Square Mile Coaching & Counselling which is based in Farringdon, London.

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